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Melanoma 1437

Melanoma
VetBooks.ir Approach to patients with oral, subungual, or cutaneous melanoma

Oral melanoma Subungual (nailbed) Cutaneous melanoma
melanoma

What is mitotic index?

≥3 per high- <3 per high-
power field power field
Staging including Staging including Staging including • Surgical excision
blood work, lymph node blood work, lymph node blood work, lymph node • Monitor for local
aspiration, thoracic aspiration, thoracic aspiration, thoracic recurrence
radiographs, ± CT scan radiographs, ± radiographs, ± • No further therapy
abdominal ultrasound abdominal ultrasound

Is distant metastasis identified?
No Yes

Treatment options:
• Palliative radiotherapy to
tumor (if significant
clinical signs from tumor)
and/or
• Melanoma vaccine and
Is regional lymph platinum chemotherapy
node metastasis (survival benefit of
identified? chemotherapy
controversial)
or
• No treatment; palliation of
Yes No signs only

Treatment options: Is excision of macroscopic tumor possible?
• Marginal excision of
primary tumor and lymph Yes No
node followed by
radiotherapy
• Limb amputation if Is radical excision ( >2 cm) of tumor possible? Treatment options:
subungual or cutaneous • Radiotherapy of
tumor on limb Yes No macroscopic tumor,
and melanoma vaccine, and
• Platinum chemotherapy platinum chemotherapy
• Melanoma vaccine
Treatment options: Treatment options:
• Radical excision of • Marginal excision of
primary tumor and primary tumor followed Clinical Algorithms
adjuvant chemotherapy by radiotherapy,
or melanoma vaccine,
• Marginal excision of and platinum
primary tumor followed chemotherapy
by radiotherapy,
melanoma vaccine, and
platinum chemotherapy

CT, Computed tomography.
UPDATED AND EDITED BY: Leah A. Cohn, DVM, PhD, DACVIM
ORIGINALLY WRITTEN BY: David R. Proulx, DVM, DACVIM

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